Heart Arrhythmia VA Rating

Most heart arrhythmia claims, including atrial fibrillation (AFib), atrial flutter and supraventricular tachycardia (SVT), are rated under Diagnostic Code 7010 at 10 or 30 percent. Since November 14, 2021, that rating turns on two things: an ECG that confirms the rhythm, and how many times a year you need a treatment intervention, meaning IV medication adjustment, cardioversion or ablation. Sustained ventricular arrhythmias, heart block and pacemakers have their own codes, and some of them pay 100 percent.

Service connection is the other half. Atrial fibrillation is not on the Agent Orange list, but ischemic heart disease is, and an arrhythmia caused or worsened by service-connected heart disease, sleep apnea, hypertension or PTSD can be granted as secondary. This page covers the rating codes word for word, what counts as a treatment intervention, the service connection routes, the C&P exam, and why VA denies arrhythmia claims.

TL;DR

• AFib, atrial flutter, SVT and sinus tachycardia are all rated under DC 7010. It pays 10 percent for one to four treatment interventions a year, or for continuous oral medication or vagal maneuvers to control the rhythm, and 30 percent for five or more treatment interventions a year. Both levels need ECG confirmation.
• A treatment intervention is IV medication adjustment, cardioversion or ablation for a symptomatic episode. Daily pills and routine ECGs do not count.
• Sustained ventricular arrhythmias (DC 7011) rate 100 percent from hospital admission for initial therapy, or with an implanted defibrillator (AICD) in place. A pacemaker (DC 7018) rates 100 percent for one month after discharge, then at least 10 percent.
• VA assigns one evaluation for DCs 7009, 7010, 7011 and 7015, under the code that reflects the predominant disability picture.
• Atrial fibrillation is not an Agent Orange presumptive disease. Ischemic heart disease is, and an arrhythmia secondary to it can be service connected under 38 CFR § 3.310.
• Across 2,550 decided Board rulings on heart arrhythmia from 2021 to 2026, 22.9% were granted, 28.6% denied and 48.5% remanded. Remand is the most common outcome.

Heart arrhythmia VA rating chart

Each rhythm problem has its own diagnostic code in the cardiovascular schedule at 38 CFR § 4.104 (opens in a new tab), rewritten effective November 14, 2021.

Two rules tie these codes together. For DCs 7009, 7010, 7011 and 7015, the schedule says "a single evaluation will be assigned under the diagnostic code that reflects the predominant disability picture." And the 60 and 100 percent levels for a weakened heart come from the General Rating Formula for Diseases of the Heart, which rates coronary artery disease (DC 7005), cardiomyopathy (DC 7020) and other heart disease. DC 7010 does not use that formula.

Tachycardia and AFib VA rating criteria (DC 7010)

DC 7010 is titled supraventricular tachycardia, and its Note (1) gives examples that include, but are not limited to, atrial fibrillation, atrial flutter, sinus tachycardia, sinoatrial nodal reentrant tachycardia, atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, atrial tachycardia, junctional tachycardia, and multifocal atrial tachycardia. So an AFib rating, an SVT rating and a tachycardia rating all come from this one code, DC 7010. The current text reads as follows.

30 percent: Confirmed by ECG, with five or more treatment interventions per year

10 percent: Confirmed by ECG, with one to four treatment interventions per year; or, confirmed by ECG with either continuous use of oral medications to control or use of vagal maneuvers to control

Note (2): For the purposes of this diagnostic code, a treatment intervention occurs whenever a symptomatic patient requires intravenous pharmacologic adjustment, cardioversion, and/or ablation for symptom relief.

Count only what Note (2) names. In a 2025 decision, the Board held that a veteran's daily metoprolol and repeated ECGs were not treatment interventions, because none of them was an IV medication adjustment, cardioversion or ablation (Board citation 25002997). Daily medication still matters, because it supports 10 percent on its own. For 30 percent, the record has to show five or more IV adjustments, cardioversions or ablations in a year. DC 7010 has no 0 percent row, so when the 10 percent criteria are not met, VA assigns 0 percent under 38 CFR § 4.31.

Before November 14, 2021, DC 7010 counted episodes instead: 10 percent for permanent (lone) atrial fibrillation or one to four episodes a year of paroxysmal AFib or other SVT documented by ECG or Holter monitor, and 30 percent for more than four documented episodes a year. For a claim pending when the rule changed, the Board applies the old criteria before that date and, from that date, whichever version is more favorable to you (Board citation 25002997, citing Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003)).

Veterans sometimes argue that AFib should be rated under the METs-based General Rating Formula to reach 60 or 100 percent. The Board has rejected that, because DC 7010 names atrial fibrillation and does not send the rater to the formula (Board citations A25006755 and A25019514). If your record also shows heart disease, see the heart disease page for how that is rated.

Source: 38 CFR § 4.104, DC 7010 (opens in a new tab).

Ventricular arrhythmias, heart block and pacemakers

DC 7011, sustained ventricular arrhythmias. The code assigns 100 percent "for an indefinite period from the date of inpatient hospital admission for initial medical therapy for a sustained ventricular arrhythmia," from admission for ventricular aneurysmectomy, or "with an automatic implantable cardioverter-defibrillator (AICD) in place." After a hospitalization, a mandatory VA exam follows six months after discharge, post-surgical residuals are rated under the General Rating Formula, and any reduction must follow 38 CFR § 3.105(e) (opens in a new tab). An AICD is rated under DC 7011, not as a pacemaker.

DC 7015, atrioventricular block. Benign block (first-degree and second-degree, type I) is rated under the General Rating Formula. Non-benign block (second-degree, type II and third-degree) is rated under DC 7018.

DC 7018, implantable pacemakers. The code assigns 100 percent for one month after hospital discharge for implantation or re-implantation. After that, VA rates the underlying rhythm as supraventricular tachycardia (DC 7010), ventricular arrhythmias (DC 7011) or AV block (DC 7015), with a minimum of 10 percent.

DC 7009, bradycardia. Symptomatic bradycardia that requires a permanent pacemaker rates 100 percent for one month after discharge, then under the General Rating Formula. Note (2) says asymptomatic bradycardia "is a medical finding only. It is not a disability subject to compensation."

On January 30, 2026, VA proposed giving DC 7009 a minimum 10 percent evaluation after pacemaker implantation, to match DC 7018, and removing its Note (1) (91 FR 4024 (opens in a new tab)). Comments closed March 31, 2026. As of October 2026 it is still a proposal, so raters apply the current text above.

How much VA pays for heart arrhythmia

For a single veteran with no dependents at the 2026 rates (effective December 1, 2025), the arrhythmia levels pay as follows.

• 10 percent pays $180.42 a month.
• 30 percent, the DC 7010 ceiling, pays $552.47 a month.
• 60 percent, reachable only under the General Rating Formula, pays $1,435.02 a month.
• 100 percent, under DC 7011, DC 7018 or DC 7009 during the periods above, or under the formula, pays $3,938.58 a month.

VA pays by your combined rating, so an arrhythmia rating adds money only when it changes the combined percentage.

Higher heart ratings: the General Rating Formula and METs

DC 7010 tops out at 30 percent. If the medical picture is really ischemic heart disease, cardiomyopathy or a sustained ventricular arrhythmia, a different code may fit better, and a rater should not force the case into DC 7010.

Since the 2021 rewrite, the General Rating Formula runs on METs (metabolic equivalents), with echocardiogram findings and continuous medication as alternatives only at the lower levels. It assigns 100 percent when a workload of 3.0 METs or less brings on heart failure symptoms, 60 percent at 3.1-5.0 METs, 30 percent at 5.1-7.0 METs or cardiac hypertrophy or dilatation on echocardiogram, and 10 percent at 7.1-10.0 METs or continuous medication. Note (3) counts arrhythmia and palpitations among the heart failure symptoms. Ejection fraction was deleted as a criterion in that rewrite, so older decisions that used a reduced ejection fraction to reach 100 percent no longer describe how VA rates.

Under 38 CFR § 4.100, METs testing is required in all cases unless there is a medical contraindication or 100 percent can be assigned on another basis. When a lab test cannot be done for medical reasons, Note (2) lets the examiner estimate METs from specific activities, such as slow stair climbing or shoveling snow.

This is also where kidney disease and cardiovascular conditions overlap. High blood pressure is a risk factor for both heart disease and chronic kidney disease (PMID 31865786), but each condition needs its own diagnosis and service connection theory.

How to prove heart arrhythmia is service connected

Direct service connection

An arrhythmia that began in service, with palpitations, an abnormal ECG or a cardiology consult in the service treatment records, supports direct service connection under 38 CFR § 3.303. Many arrhythmias are first diagnosed years after service, though, and then the claim usually runs through another service-connected condition.

Agent Orange: ischemic heart disease, not AFib

The herbicide list at 38 CFR § 3.309(e) (opens in a new tab)) includes ischemic heart disease, including past heart attack, coronary artery disease and angina. Atrial fibrillation, SVT and other rhythm disorders are not on it. Qualifying exposure includes service in Vietnam from January 9, 1962 to May 7, 1975 and work on C-123 spray aircraft (38 CFR § 3.307(a)(6)), and service in or near the Korean DMZ from September 1, 1967 to August 31, 1971 (38 U.S.C. § 1116B; § 3.307 still prints April 1, 1968). The PACT Act (August 10, 2022) added service at any U.S. or Royal Thai base in Thailand, and in Laos, parts of Cambodia, Guam, American Samoa and Johnston Atoll, each for set periods (38 U.S.C. § 1116(d)). It also added hypertension to the herbicide diseases in the statute (38 U.S.C. § 1116(a)(2)(M)), though § 3.309(e) has not been updated to list it.

The route that works is a chain. The presumption establishes the ischemic heart disease, and a cardiologist explains how that heart disease caused or worsened the arrhythmia. The cardiology record should document the coronary disease, any heart attack, stent or bypass, the rhythm diagnosis and the link between them. Without that bridge, the presumption helps the heart disease but leaves the rhythm disorder exposed. In the Board's 2021 to 2026 service connection rulings, arrhythmia argued as presumptive rarely won, and secondary claims were granted more often than direct ones; the Board section below shows the rates.

Heart arrhythmia secondary to sleep apnea, hypertension or PTSD

Not every arrhythmia claim is a herbicide case. Secondary service connection under 38 CFR § 3.310 (opens in a new tab) covers an arrhythmia caused by a service-connected condition, or aggravated by it, meaning it would be less severe but for that condition (38 CFR § 3.310(b), M21-1 V.ii.2.D).

• Sleep apnea: a 2022 meta-analysis of 20 studies found an 88 percent higher incidence of AFib in people with obstructive sleep apnea, with age and hypertension strengthening the link (Moula and colleagues, Journal of Clinical Medicine, PMID 35268335).
• PTSD: in a VA cohort of 988,090 young and middle-aged veterans, PTSD was associated with a higher risk of new AFib after adjusting for other risk factors and depression (Rosman and colleagues, Journal of the American Heart Association, 2019, PMID 31564191).
• Hypertension: a 2020 review found that large cohort studies show high blood pressure is an important risk factor for atrial fibrillation, as well as heart failure and kidney disease (Fuchs and Whelton, Hypertension, PMID 31865786).

These are associations, not proof in your case. The opinion still has to name the arrhythmia subtype, the service-connected condition, the mechanism, the timeline and the competing causes, and it has to address aggravation as well as causation. An opinion that skips aggravation is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)). Secondary condition pathways from heart conditions can help decide whether the strongest anchor is ischemic heart disease, sleep apnea, hypertension, PTSD, thyroid disease, kidney disease or another diagnosed primary. Secondary conditions to hypertension and secondary conditions to PTSD cover the conditions claimed secondary to each and the Board's numbers for them.

One special rule: ischemic heart disease or other cardiovascular disease that develops in a veteran with a service-connected amputation of one leg at or above the knee, or of both legs at or above the ankles, is held to be caused by the amputation (38 CFR § 3.310(c)).

What a strong arrhythmia nexus opinion covers

The opinion should name the specific arrhythmia, tie it to the in-service evidence or to the service-connected primary condition, and address the alternatives an examiner will raise: hypertension, ischemic disease, sleep apnea, thyroid disease, electrolyte problems, alcohol use and age. The Board section below shows how arrhythmia claims went when the Board relied on a favorable opinion, an opinion against the claim, or none.

The heart arrhythmia C&P exam

DC 7010 rates on countable events, so the file needs countable data: ECGs and Holter or event-monitor reports confirming the rhythm, emergency department visits, cardioversion and ablation records, IV medication adjustments, hospitalizations for rate control, the medication list and your own symptom log. Use an evidence checklist for cardiology opinions and track episodes and symptoms over time before the exam. A cardiologist cannot count interventions that the record never preserved, and the C&P exam prep tool can help you get ready for the cardiac exam.

Arrhythmia exams fail in predictable ways. The examiner does not count treatment interventions, does not review the Holter or event-monitor data, ignores cardioversion or ablation records, lists antiarrhythmic medication without saying what it controls, or gives a generic age-related explanation without addressing herbicide exposure, ischemic disease, sleep apnea, hypertension, thyroid disease or PTSD.

The pushback should name the missing piece. "The exam was inadequate" is weaker than "the examiner did not discuss the three cardioversions in the past year, did not address the cardiologist's ischemic heart disease diagnosis, and did not explain why herbicide exposure was not relevant." Once VA gives an exam, it has to be an adequate one (Barr v. Nicholson, 21 Vet. App. 303 (2007)). When the Board sends arrhythmia claims back, an inadequate VA exam or opinion is the most common reason; the Board section below shows the remand reasons.

Why VA denies heart arrhythmia claims

Across 2,550 decided Board rulings on heart arrhythmia from 2021 to 2026, 22.9% were granted, 28.6% denied and 48.5% remanded. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. The grant rate is 1.8 percentage points below the 24.7 percent across all decided Board rulings, and the remand share is above the 45.3 percent across all decided Board rulings. When the Board denied arrhythmia service connection, it most often found no link between the arrhythmia and service; the Board section below shows how often each part of the claim failed and how appeals have gone since 1992.

The same gaps repeat in the decisions.

No link to service. The arrhythmia started years after separation, there is no in-service treatment, and no opinion explains a secondary chain.

AFib argued as an Agent Orange disease. Atrial fibrillation is not on the herbicide list. The claim needs the ischemic heart disease in the record and an opinion that connects the two.

No ECG confirmation. Both DC 7010 levels require it. A patient report of palpitations is not enough.

Treatment interventions missing or miscounted. Cardioversions and IV medication adjustments scattered across emergency department notes are a 30 percent fact only if the record shows all of them, and daily pills do not count toward that level.

A thin exam. An exam that skips the procedure history or the competing causes gives the Board a reason to remand rather than grant.

The wrong code. A sustained ventricular arrhythmia, an AICD, a pacemaker or heart disease measured in METs belongs under its own code, and DC 7010 caps the rating at 30 percent.

Questions veterans ask about heart arrhythmia

What is the VA rating for AFib or SVT?

Both are rated under DC 7010 at 10 or 30 percent. You get 10 percent with ECG confirmation and one to four treatment interventions a year, or continuous oral medication or vagal maneuvers to control it, and 30 percent with five or more treatment interventions a year.

Do daily heart medications count as treatment interventions?

No. A treatment intervention is IV medication adjustment, cardioversion or ablation for a symptomatic episode. Continuous oral medication supports the 10 percent level, but it does not count toward the five interventions needed for 30 percent.

Is atrial fibrillation an Agent Orange presumptive condition?

No. The herbicide list at 38 CFR § 3.309(e) covers ischemic heart disease, not atrial fibrillation. AFib can still be service connected as secondary to presumptive ischemic heart disease when a medical opinion links the two.

Can AFib be rated separately from coronary artery disease?

It can when the AFib has findings the heart rating does not cover. In a 2025 decision the Board granted a separate 10 percent under DC 7010 for AFib needing cardioversion one to four times a year, because the METs-based heart rating does not count treatment interventions (Board citation A25011524). Symptoms such as fatigue, breathlessness or palpitations already count toward the heart rating, and 38 CFR § 4.14 bars rating the same manifestation twice.

What VA rating does a pacemaker get?

DC 7018 assigns 100 percent for one month after hospital discharge for the implant. After that, VA rates the underlying rhythm under DC 7010, 7011 or 7015, with a minimum of 10 percent. An implanted defibrillator (AICD) is rated under DC 7011 instead, at 100 percent while it is in place.

Is there a VA rating for bradycardia?

Under DC 7009, only when it is symptomatic and needs a permanent pacemaker: 100 percent for one month after discharge, then the General Rating Formula. Asymptomatic bradycardia is a medical finding, not a compensable disability, and heart block has its own code, DC 7015. VA proposed a 10 percent minimum after a pacemaker in January 2026, but that is not final.

Bottom Line

Most arrhythmia ratings come from DC 7010, which pays 10 or 30 percent on ECG confirmation and a count of treatment interventions: IV medication adjustments, cardioversions and ablations. Sustained ventricular arrhythmias, AICDs and pacemakers have their own codes that pay 100 percent for set periods, and the 60 and 100 percent levels for a weakened heart run through the METs-based General Rating Formula. Across 2,550 decided Board rulings on heart arrhythmia, remand is the most common outcome, and the grant rate is 1.8 percentage points below the Board-wide 24.7 percent. The claims that hold up do three things: they build the chain through a service-connected primary condition such as ischemic heart disease, sleep apnea, hypertension or PTSD when the arrhythmia came later; they bring a cardiology opinion that addresses causation, aggravation and competing causes; and they document every treatment intervention with a date.

Related Conditions

Heart arrhythmia claims commonly connect to heart disease, cardiomyopathy, hypertension, sleep apnea, PTSD, kidney disease and thyroid conditions. Veterans with episodic rhythm disorders should preserve monitor data and review the C&P exam prep tool before the cardiac exam.

Methodology and Limitations

• Data source: Board figures come from Claim Raven's read of every Board decision from 2021 to 2026 that it holds, 511,036 decisions containing 1,378,030 rulings. Rating criteria are quoted from 38 CFR § 4.104 (DCs 7009, 7010, 7011, 7015 and 7018 and the General Rating Formula, effective November 14, 2021, 86 FR 54089) and § 4.100, checked against the eCFR text current to October 2, 2026. Service connection rules come from 38 CFR §§ 3.303, 3.307(a)(6), 3.309(e) and 3.310 and 38 U.S.C. §§ 1116 and 1116B, checked against the text of the PACT Act (Pub. L. 117-168) and the Blue Water Navy Act (Pub. L. 116-23). The bradycardia proposal is 91 FR 4024 (January 30, 2026); the Federal Register showed no final rule on October 10, 2026. Board practice on DC 7010 is drawn from Board citations 25002997, A25006755, A25011524 and A25019514. Study findings are cited by PMID. 2026 compensation rates (effective December 1, 2025) are for a veteran with no dependents.
• Sample size: 2,550 decided Board rulings on heart arrhythmia (2,808 rulings in all, counting dismissed and withdrawn issues): 22.9% were granted, 28.6% denied and 48.5% remanded. The Board section on this page breaks these down by denial reason, remand reason, what happened after a remand, appeal type, medical opinion, claim theory and era since 1992; those figures are computed from the data, not typed here.
• Limitations:
• The 2,550 decided arrhythmia rulings are issues that reached the Board, not all arrhythmia claims filed with VA. Claims granted at the regional office without appeal are not in this dataset.
• Arrhythmia subtype (paroxysmal or persistent atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular arrhythmias) is not coded consistently.
• Treatment intervention counts, METs and other clinical measures that drive the rating are not coded, and neither is the rating level granted.
• Claim theory is coded from the Board's discussion, and a case may argue several theories in the alternative. A presumptive claim is also counted as direct or secondary.
• Medical opinion figures are read from the decision itself, so they partly restate the outcome.
• Decisions in the 2021 to 2026 window often apply the pre-November 14, 2021 criteria to the earlier part of a claim.
• These observations describe Board patterns. They are not predictions of individual outcomes, and Claim Raven is data analysis, not legal, medical or VA-accredited advice.